Abstract 31

BACKGROUND: Feeding with human milk can minimize morbidities associated with high-risk infants. Adolescent mothers have increased probability of delivering high-risk neonates, yet little is known about the prevalence of breastfeeding, motivators or effects of intervention in this age group. We have previously reported our findings on this subject in a group of nulliparous adolescents. We now report the effects of parity on attitudes and perceptions towards breastfeeding in a similar cohort. METHODS: A cross-sectional survey was undertaken among 30 post-partum and 29 nulliparous women aged 13-19. The instrument included 39 statements scored on a 5-point Likert scale, followed by 18 open and closed ended questions administered by the PI. An additional 23 questions were posed to the parous group, to elicit the impact of pregnancy on beliefs about breastfeeding. Statistical analysis, using SAS statistical software, included descriptive statistics and chi-square analysis. RESULTS: Both groups were mostly Afro-American, average age 16 years. 46% of babies were to be cared for by the mother's mother or grandmother. The paras differed from the nulliparas in school attendance (63% vs 83%), religious affiliation (70% vs 93%), decision to formula feed (60% vs 45%), decision to breastfeed (24% vs 14%), and acceptability of breastfeeding in public (63% vs 24%). Feeding decision was more frequently their own (64% vs 41%) or influenced by health care providers (7% vs 1%). Of the 17% with other children, 40% had previously breastfed. Likert scale questions regarding attitudes and perceptions towards breastfeeding were divided into the following positive and negative categories: self-image, process perceptions, emotional perceptions, outside influences. Negative attitudes previously reported in the nulliparous group persisted among the parous group, with the additional following negative responses: "Breastfeeding hurts." "My mother wants me to bottlefeed." Positive responses from the parous group, distinct from the nulliparous respondents, included (among others): "Breastfeeding is the healthiest feeding for my baby" and "Breastfeeding would be good for me and my baby." 30% of parous women vs. 62% of nulliparas reported they "did not know enough about breastfeeding." CONCLUSION: Parous adolescents are less likely to be in school or to claim a religious affiliation. Misinformation among adolescents regarding the benefits of breastfeeding and a lack of social support persists after delivery, but health care providers have some influence on feeding choice. Of note, parous women showed less interest in learning about breastfeeding. This suggest that, to be maximally effective, educational efforts to promote breastfeeding in this age group should be targeted to the pre-pregnant and prenatal periods.